[Pudov Surgical care in a multi-field hospital during the new coronavirus infection pandemic (SARS-COVID-19): a 5-year experience]. / Okazanie khirurgicheskoi pomoshchi v mnogoprofil'nom «nekovidnom¼ statsionare v period pandemii novoi koronavirusnoi infektsii (SARS-COVID-19). Pyatiletnii opyt.

OBJECTIVE: To analyze the 5-year experience of surgical care in a multi-field hospital during the coronavirus pandemic and before infection. MATERIAL AND METHODS: We assessed «non-traumatic¼ surgery and the main indicators in a multi-field hospital during the coronavirus pandemic and surgical work in the «pre-COVID¼ period. RESULTS: The number of discharged patients was the same between 2018 and 2021. In 2020-2021, mortality increased by 2.8 times, the number of deceased patients - by 2.5 times, hospitalizations for emergency surgical indications - by 2.1 times. Elective care decreased by 2.5 times. The number of adverse vascular events increased by 3 times. CONCLUSION: Acute increase in emergency surgery and decrease in elective care create the prerequisites for growth of «neglect¼ with subsequent postoperative complications. We observed significant increase in mortality. It is advisable to create a backup emergency surgical service in infectious disease hospitals to provide care in obviously infected patients.

Possibilities of Multilayer Perceptron in Complexing Risk Factors of Diabetic Foot Syndrome.

The levels of markers of endothelial dysfunction, MMP9, and polymorphisms of genes of vascular tone regulation factors, platelet receptors, vascular wall remodeling and prothrombotic factors, and markers of endothelial dysfunction were studied in patients with complicated and uncomplicated diabetes mellitus. It was found that the neural network analysis of these data makes it possible to predict the development of diabetic foot syndrome with an accuracy of 92.9%. The high accuracy of neural network analysis is due to the multifactorial nature of the diabetic foot syndrome.

Technology for Quantifying the Postpartum Blood Loss.

The aim of the study was to develop a technology for determining postpartum hemorrhage volume based on gravimetry and 3D modeling of the results of the US postpartum uterus examination. MATERIALS AND METHODS: The study was conducted at the perinatal center of the Regional Clinical Hospital (Chita) and the Kuvatov Republican Clinical Hospital (Ufa). A prospective analysis of 40 births from 2018-2019 was performed. Two groups were formed: group 1 - 30 women with physiological blood loss in the postpartum period; group 2 - 10 women with early hypotonic bleeding.The volume of blood loss was determined in three ways: visually, by a gravimetric method, and by the integrated use of the gravimetric method and 3D modeling of the results of US of postpartum uterine cavity. Uterus sonography in the early postpartum period was performed with a MySono U6 portable ultrasound scanner (Samsung Medison, Korea). Using local systems for changing the positions of points, lines, and polygons, the Autodesk 3ds Max program was tuned to simulate the shape of the postpartum uterus, which changed dynamically in accordance to the input ultrasound parameters. RESULTS: In group 1, the volume of postpartum blood loss was quantified by the visual method as 275.0 (267.2; 282.8) ml, by the gravimetric method - as 375.0 (364.5; 388.2) ml, and by a combination of the gravimetric method and sonography-based 3D modeling of the postpartum uterus - as 420.0 (412.5; 435.4) ml. In group 2, the volume of postpartum blood loss was estimated visually as 725.0 (716.8; 773.2) ml, by gravimetry - as 1010.0 (1006.2; 1085.7) ml, and by gravimetry combined with the 3D modeling of the uterine cavity - as 1240.0 (1195.4; 1286.6) ml. CONCLUSION: The proposed technology allows one to determine the volume of postpartum hemorrhage with a minimum error making it possible to reduce the frequency of massive postpartum bleeding and optimize the management of patients with medium and high risks.

Inflammatory Proteins as Molecular Markers in the Diagnosis of Cervical Oncopathology.

Imperfection of cytological diagnostics of cervical cancer has prompted the search for alternative methods of pathology detection. The aim of the study was to evaluate the effectiveness of inflammatory proteins as molecular markers in the diagnosis of cervical oncopathology. MATERIALS AND METHODS: A prospective controlled trial was conducted with three groups of women: group 1 (n=13) - with precancerous pathology (cervical intraepithelial neoplasia of grade III); group 2 (n=49) - patients with cervical cancer; group 3, control (n=13) - gynecologically healthy women (mean age - 30.0±4.4 years).The material for the study was cervical epithelium, which was taken according to the standard technique using a cytobrush from the junction zone of cervical. The levels of inflammatory proteins (SAA, ICAM-1, VCAM-1, and sCD27) in the cervical epithelium were determined by flow cytometry. RESULTS: Molecular criteria for the presence of precancerous pathology and cervical cancer have been found to be a 3.10 [1.31; 3.28] fold increase in SAA values (U=41.0, p=0.02), 2.62 [2.79 3.50] fold (U=137.0, p=0.001) in ICAM-1, 5.20 [3.84; 12.37] fold (U=138.5, p=0.001) in VCAM-1, and 4.32 [2.07; 5.02] fold (U=109.0, p<0.001) in sCD27 in cervical epithelium compared with the control group data. The COP (cervical oncoproblem) coefficient was developed to calculate the probability of cervical oncological pathology presence with the accuracy of 90%. An application for Android was created in Delphi development environment to simplify its calculation. CONCLUSION: The created technology makes it possible to establish the diagnosis in the shortest possible time and to optimize the treatment and diagnostic process by accelerating the examination period and improving its accuracy.